Serum potassium level is associated with metabolic syndrome: A population-based study
ABSTRACT Evidence has suggested that low serum potassium concentration or low dietary potassium intake can result in many metabolic disorders. Our objective was to evaluate the association between serum potassium level and risk of prevalent metabolic syndrome.
We conducted a cross-sectional study in 10,341 participants aged 40 years or older. Metabolic syndrome was defined according to guidelines from the National Cholesterol Education Program with modification.
The prevalence rate of metabolic syndrome was 51.7% in participants with hypokalemia and 37.7% in those with normokalemia. With the reduction of serum potassium quartiles, participants were tended to have higher level of triglycerides and uric acid, lower level of high-density lipoprotein cholesterol (HDL-C), larger waist circumference and more severe insulin resistance. Serum potassium level significantly decreased with the increasing number of metabolic syndrome components. Compared with subjects in the highest quartile of serum potassium level, multivariate adjusted odds ratios for prevalent metabolic syndrome in the lowest quartile was 1.48 (95% confidence interval, 1.16-1.87). Moreover, compared with subjects without central obesity, hypertriglyceridemia, low HDL-C and elevated fasting plasma glucose, those with each of these metabolic syndrome components have lower level of serum potassium after adjusted for age and sex.
Low serum potassium level significantly associated with prevalence of metabolic syndrome in middle-aged and elderly Chinese.
- [Show abstract] [Hide abstract]
ABSTRACT: An impairment of glucose metabolism, contributing to the increased cardiovascular risk, has been shown in primary aldosteronism (PA). Insulin resistance is associated with nonalcoholic fatty liver disease (NAFLD) and may play a role in its pathophysiology. The aim of this study was to investigate the association between NAFLD and PA, and to identify determinants of NAFLD in this condition. A total of 40 patients with PA, 40 sex-, age-, and body mass index matched patients with low-renin essential hypertension (LREH) and 40 normotensive subjects were studied. According to ultrasound detection of fatty liver, each group was subdivided in two subsets: with NAFLD and without NAFLD. Patients with diabetes, obesity, and hyperlipidemia were excluded. Prevalence of NAFLD in PA was similar to that observed in LREH patients, and higher (P < 0.01) than in normotensive controls. Serum potassium was lower in PA than in LREH patients with NAFLD (P < 0.001), while it was similar in PA and LREH patients without NAFLD. At univariate analysis, plasma aldosterone, homeostasis model assessment (HOMA) index and hypokalemia were determinants of NAFLD in PA (P < 0.05), while HOMA index was associated with NAFLD in LREH (P < 0.05). At multivariable analysis, only hypokalemia remained associated with NAFLD in PA (P = 0.02). The results of this pilot study suggest that, in the absence of major risk factors for liver disease, NAFLD is a frequent finding in PA. Patients with PA and hypokalemia are more insulin resistant and have higher prevalence of NAFLD than those with normokalemia, indicating greater risk for metabolic and liver disease in this subgroup.American Journal of Hypertension 11/2009; 23(1):2-5. DOI:10.1038/ajh.2009.206 · 3.40 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Serum potassium levels affect insulin secretion by pancreatic β-cells, and hypokalemia associated with diuretic use has been associated with dysglycemia. We hypothesized that adults with lower serum potassium levels and lower dietary potassium intake are at higher risk for incident diabetes mellitus (DM), independent of diuretic use. We analyzed data from 12 209 participants from the Atherosclerosis Risk in Communities (ARIC) Study, an ongoing prospective cohort study, beginning in 1986, with 9 years of in-person follow-up and 17 years of telephone follow-up. Using multivariate Cox proportional hazard models, we estimated the hazard ratio (HR) of incident DM associated with baseline serum potassium levels. During 9 years of in-person follow-up, 1475 participants developed incident DM. In multivariate analyses, we found an inverse association between serum potassium and risk of incident DM. Compared with those with a high-normal serum potassium level (5.0-5.5 mEq/L), adults with serum potassium levels lower than 4.0 mEq/L, 4.0 to lower than 4.5 mEq/L, and 4.5 to lower than 5.0 mEq/L had an adjusted HR (95% confidence interval [CI]) of incident DM of 1.64 (95% CI, 1.29-2.08), 1.64 (95% CI, 1.34-2.01), and 1.39 (95% CI, 1.14-1.71), respectively. An increased risk persisted during an additional 8 years of telephone follow-up based on self-report with HRs of 1.2 to 1.3 for those with a serum potassium level lower than 5.0 mEq/L. Dietary potassium intake was significantly associated with risk of incident DM in unadjusted models but not in multivariate models. Serum potassium level is an independent predictor of incident DM in this cohort. Further study is needed to determine if modification of serum potassium could reduce the subsequent risk of DM.Archives of internal medicine 10/2010; 170(19):1745-51. DOI:10.1001/archinternmed.2010.362 · 13.25 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Low serum potassium appears to be independently associated with incident type 2 diabetes, and low dietary potassium is more common in African Americans than in whites. We hypothesized that low serum potassium contributes to the excess risk of diabetes in African Americans. We analyzed data collected from 1987 to 1996 from the Atherosclerosis Risk in Communities (ARIC) Study. At baseline, we identified 2716 African American and 9493 white participants without diabetes. We used multivariate Cox models to estimate the relative hazards (RHs) of incident diabetes related to baseline serum potassium during 9 y of follow-up. Mean serum potassium concentrations were lower in African Americans than in whites at baseline (4.2 compared with 4.5 mEq/L; P < 0.01), and African Americans had a greater incidence of diabetes than did whites (26 compared with 13 cases/1000 person-years). The adjusted RHs (95% CI) of incident diabetes for those with serum potassium concentrations of <4.0, 4.0-4.4, and 4.5-4.9 mEq/L, compared with those with serum potassium concentrations of 5.0-5.5 mEq/L (referent), were 2.28 (1.21, 4.28), 1.97 (1.06, 3.65), and 1.85 (0.99, 3.47) for African Americans and 1.53 (1.14, 2.05), 1.49 (1.19, 1.87), and 1.27 (1.02, 1.58) for whites, respectively. Racial differences in serum potassium appeared to explain 18% of the excess risk of diabetes in African Americans, which is comparable with the percentage of risk explained by racial differences in body mass index (22%). Low serum potassium concentrations in African Americans may contribute to their excess risk of type 2 diabetes relative to whites. Whether interventions to increase serum potassium concentrations in African Americans might reduce their excess risk deserves further study. The ARIC Study is registered at clinicaltrials.gov as NCT00005131.American Journal of Clinical Nutrition 03/2011; 93(5):1087-91. DOI:10.3945/ajcn.110.007286 · 6.92 Impact Factor